Growth, Development and Health Flashcards
List the recognised phases of childhood
- Neonate (<4wks)
- Infant (<12m/1yr)
- Toddler (1-2yrs)
- Preschool (2-5yrs)
- School age
- Teenager/adolescent
List the main childhood objectives
- To grow
- To develop and achieve their potential
- To attain optimal health
- To develop independence
- To be safe
- To be cared for
- To be involved
List the key developmental fields
- Gross motor
- Fine motor
- Hearing and vision
- Speech and language
- Social and self help
List the key milestones and when they should roughly be reached
- Smiling (4-6wks)
- Sitting (6-7 months)
- First words (1yr)
- Walking (9-18 months)
Which factors influence development?
- Genetics
- Environment
- Positive early childhood experience
- Insults: antenatal, post natal, abuse and neglect
Name the adverse antenatal environmental factors that affect development
- Infections (CMV, rubella etc.)
- Toxins (alcohol, smoking etc.)
Name the adverse post natal factors which affect development
- Infection (meningitis etc.)
- Toxins
- Trauma (head injuries)
- Malnutrition
- Metabolic (hypoglycaemia and hyper/hyponatraemia)
- Maltreatment/ understimulation/ domestic violence
- Maternal mental health issues
How is development assessed?
- Healthy Child Programme
- Screening (may not be sensitive/specific)
- Parental concerns
- Red book
- Observation of play and activity
- Medical history and exam
What are the red flags for development?
- Loss of developmental skills
- Parental/professional concern
- Hearing loss
- Persistent low muscle tone/ floppiness
- No speech by 18 months
- Asymmetry of movements/increased muscle tone
- Not walking by 18 months
- OFC > 99.6th/<0.4th
- Clinician uncertainty
Describe the Child Health Programme steps
- New born exam and blood spot screening
- New born hearing screening
- Health visitor first visit
- 6-8 week review
- 27-30 month review
- Orthoptist vision screening
What is performed at the 6-8 week review?
- Identification
- Feeding
- Parental concerns
- Development
- Measurements
- Examination (top to toe)
- Sleeping position
What is performed at the 27-30 month review?
- Identification
- Development
- Physical measurements
- Diagnoses/other issues
What are the 3 key parameters for growth monitoring?
- Weight
- Length
- Head circumference
Name the derived measurements for growth monitoring
- Weight for age
- Length for age
- BMI
- Weight for length
- Rate of weight gain (infants only)
What is failure to thrive?
Child growing too slowly in form and usually in function at the expected rate for his or her age
List the maternal causes of failure to thrive in early life
- Poor lactation
- Incorrectly prepared feeds
- Unusual milk or other feeds
- Inadequate care
List the infant causes of failure to thrive in early life
- Prematurity
- Small for dates
- Oropalatal abnormalities e.g. cleft palate
- Neuromuscular disease
- Genetic disorders
List the increased metabolic demands that can cause failure to thrive
- Congenital lung disease
- Heart, liver and renal disease
- Infection
- Anaemia
- Inborn errors of metabolism
- CF
- Thyroid disease
- Crohn’s/IBD
- Malignancy
List the excessive nutrient loss conditions which can cause excessive nutrient loss
- Gastro-oesophageal reflux
- Pyloric stenosis
- Gastroenteritis
- Malabsorption
List the non medical causes of failure to thrive
- Poverty/socio-economic status
- Dysfunctional family interactions
- Difficult parent-child interactions
- Lack of preparation for parenting
- Child neglect
- Emotional deprivation
- Poor feeding or feeding skills disorder
How should a failure to thrive be investigated?
- History
- Examination
- Trial of feeding in hospital
